Big Picture: Evaluating Your Digestive Healing Plan

This is a guest post series from Matt Robinson, digestive illness coach at Natural Digestive Healing.

This is the last post in our Big Picture series. (Read Post One, Post Two, Post Three) If you are using this series to its fullest, remember to get out a pen and paper so you will be ready to jot down ideas and think about the questions and concepts posed along the way.

In the first post, I discussed the value of a big picture outlook, and introduced the concepts of balance and prioritization as they relate to healing from digestive illness. In the second post, I expanded on those concepts, and walked through the first steps of developing a big picture-focused healing plan. In the third post, we used your Go-sion and your SMART goals to design a healing plan.

In this post we will ask four questions:

1. How do I know if my plan is working; how will I know if I need to change something?
2. How can I discern trends, either positive or negative?
3. If I need to change something, how will I know what to change?
4. What is the (hard and simple) secret to healing?

Knowing Your Body; Observing Healing

As you implement your healing plan, how will you know what is working and what is not?

The answer: your diet/symptom journal.

Your journal will help you to know your body. On the whole, those people who journal consistently heal more often and in less time than those who do not. Journaling consistently will help you see trends, identify foods and supplements that are safe and those that are not, and it will remind you how far you have come.

Two weeks ago, I was frustrated because I had a recurrence of some symptoms I thought I had gotten over. I thought, “Why haven’t I gotten any better? I was better last year, after my elimination.” Those thoughts plagued me for a week. I thought I was stagnating, or getting worse, until I looked back at my journal. As it turns out, I had been carrying a rosy picture of how well I actually was after I cut out the four horsemen of the Specific Carbohydrate Diet. I did get better then, but the diet/symptom journal does not lie, and it told me that I was going 2-3 times/day then with an average Bristol stool rating of 5-6. Now I rarely go more than once/day, and I have many more #4 ratings than I did then. Progress! I was still moving forward, but would never have seen it if it were not for my journal.

Think about: Does your Journal play a central role in your healing? What do you know about your body now that can inform your healing plan?

Warning: Most of the time a thorough journal will help you understand what is going on, but there are times when it does not—that is the nature of digestive illness. In the first post of this series, I wrote about making friends with uncertainty.

Identifying Trends

What is a trend?

Through journaling, you will learn how long it takes for irritating foods or supplements to manifest symptoms. You will learn how long it takes for each healing modality you use to begin working. You will also learn how quickly you can expect to recover from a bump in the road. The question is, how do you discern those road bumps from other more ominous signs, like the signs of a flare or a supplement that is hurting and not helping?

There is no single answer that applies to every person; however, if you are thoughtful in journaling and reviewing your journal, and if you are disciplined in implementing your healing plan, then over time you will learn how long adverse symptoms, or positive improvements need to go on before you can consider them trends.

For me, I have learned that if my symptoms worsen, and then continue to worsen for more than 48 hours, I have a problem, and I go to my journal to see what’s happening. For example, in February of this year, I decided to try Butyrate enemas, one per day, starting at a small dose. At the time, I was having 1-2 BM/day at 5-6 on the Bristol Stool Chart. I took the first enema at night. The next day I had three BMs all at a #6. Might be a reaction; might just be getting used to the medicine.

I continued.

The next day I had three BM at a #7—complete diarrhea. OK, something is going on, but it might settle. The third day, I went five times at a #7. STOP!

Alright, so I did not need a journal to figure that one out, but the point remains: I learned through two years of journaling, that 2-3 days signifies a negative trend for my body. On the other side, I have also learned that 5-6 days are necessary for me to count positive progress as permanent.

Note from Steve: This is a great insight about how to spot trends. I just want to point out 2 things. (1) Matt saw a worsening of his problems for 3 days. It likely took him 3 days more before he was back to himself, so don’t forget about the bounce back.  (2) Not every minor bump looks like this. Sometimes you’ll notice a regression in all areas of BM’s like Matt did, but instead of getting worse and worse each day it will just stay slightly worse. So, journaling is needed to pick up this minor trend at the end of the week when you’ve made a small change like cooked to raw foods, or a new food.

Think about: Look at your journal entries (no matter how many you have) and see what you can discern about your body, about your diet, and about other healing strategies you are using. Are they helping? Hurting? How will you know?

When to Add, Change, Modify

Even the best natural healing modality, when added at the wrong time, or done haphazardly can lack the desired effect, or worse, cause problems. Healing happens in layers, over time, and so your healing strategies also must be added in layers, over time.

The healing pyramid from previous posts in this series is meant to be a guide to help you organize healing strategies into a plan; it should also help you evaluate and re-work your plan should the need arise. Spend time tweaking and working on the most effective healing strategies first (like diet, probiotics, and other gut-specific treatments).

It is important, if you feel that your healing plan is not working, that you re-evaluate it. Check to ensure that you are adding the most effective strategies first, like diet and probiotics. Check to ensure that you have implemented those strategies in the way they were meant to be implemented and for the effective time period. For SCD, give yourself 30-45 days without cheating before you re-evaluate. For probiotics, three to six weeks. For Low Dose Naltrexone (LDN), another example, it could be three to six months before you see the full desired effect.

If you encounter a good healing strategy (like Butyrate enemas), and it does not work for you today, keep it, and try it again in a year. It may be that your body needs more time before it can utilize that particular healing strategy. It is true that some strategies might not work at all for you, and that is good to know, but it would be a shame to throw out a perfectly good hammer before you have driven in all of the nails.

Yes—I have kept the Butyrate for another day.

Think about: What in your healing plan might need to change? Is it organized and implementable?

Trying New Approaches

If an approach simply does not work for you, toss it, no matter how many people it has helped. Make sure first that you have done it right, done it fully, and done it flawlessly. I will use the SCD as an example:

Elaine Gottschall, who popularized and solidified the Specific Carbohydrate Diet, which has helped thousands of people to heal, freely admitted that the SCD does not work for everyone. Her experience was that about 95% of people with Crohn’s and about 75% of people with colitis benefited from the diet. That’s good news; the SCD will likely work for you. This is a big reason diet should be the cornerstone of your healing plan.

Note from Steve: In general, I don’t agree with Elaine at all. SCD or eating a custom version of the SCD diet will give you the best chance from food to heal.  The term “work” is undefined and means something different wherever you are. What is defined is that there are many foods that cause inflammation, leaky gut and are toxic to the body. Eating those foods will hurt your healing or stop it if you choose them.

However, the SCD per se does not work for everyone. If you do it for 30-45 days without cheating; if you have personalized it, tweaked it, and extended it to its fullest, and it still does not work, that is okay. There are other dietary strategies, just like there are other supplement regimens to try, other stress relief ideas, etc.

If a healing strategy simply does not work for you, muster the courage to chuck it.

Think about: Evaluate your healing strategies. Are you implementing them properly, and for the full time period (so long as they don’t make you worse)? What approaches are you taking which need to be re-evaluated? What strategies can replace them, and where do they fit on the pyramid?

The (Hard and Simple) Secret to Healing

The secret to maximizing the potential for healing is so simple many people I talk with at first want to dismiss it:

Take responsibility for your illness.

That is what this series is all about, really. In fact, that is what natural healing philosophy comes to in the end; in taking responsibility for our illness, we are free to take control of our healing. It is difficult to do, especially for us Americans who are used to an easy (medical) convenience which is only afforded by a shortage of responsibility.

It was hard for me to hear at first—that I had a role in my illness. I wanted to be a victim, a causality of choices over which I had no control. But when I thought of it, I did have a role. I can think of dozens upon dozens of times where I betrayed my body. Sure, I could not control the fact that I was not breast fed as an infant, and I had no say over the antibiotics I took as a young child. But there was a lot I could control, and there is a lot I can control now.

It was a milestone in my healing journey, when I stopped blaming the world for my illness and took responsibility for the role I played in getting sick. When I finally did that (it was a long road), I began to feel free from all the junk I was holding onto: blame, anger, doubt, shame, uncertainty. Oh, they are still there for sure, but they no longer have any power. I took responsibility for my illness.

And the best next step? Take responsibility for my healing.

With that said, I want to issue you one last challenge. If you have been journaling or taking notes throughout this series, this would be a good way to wrap up your healing plan.

Think about your past: What factors may have influenced your road to digestive illness? What role did you play in developing illness? What factors were under your control?

Note from Steve: I added the bolding above, this is quite possibly the most powerful question written in over 200+ posts on our blog. When you ask it, don’t look for an immediate answer just keep asking and thinking about it.

Think about your present: What would it feel like to let go of those past factors (yours or not) that may have contributed to your illness? What factors can you control now? What can you do today to take control of your healing journey?

Think about your future: What next step(s) do you want to take (something you can do this week) that will help move you towards healing?

Onward to health,

Matt